Candidates for trial of labor

One or two prior low-transverse cesarean deliveries

Clinically adequate pelvis

No other uterine scars or previous rupture

Physician immediately available throughout active labor, capable of monitoring labor and performing emergency cesarean delivery

Availability of anesthesia and personnel for emergency cesarean delivery

Circumstances under which a trial of labor should not be attempted

Prior classic or T-shaped incision or other transfundal uterine surgery

Contracted pelvis

Medical or obstetric complication that precludes vaginal delivery

Inability to perform emergency cesarean delivery because of unavailable surgeon, anesthesia, sufficient staff, or facility